Do you have a tickle in your throat?
How about a slight cough?
The local health-care community is reeling this week due to people flocking to assessment centres and hospitals county-wide to see if they should get tested for COVID-19.
But according to officials from Royal Victoria Regional Health Centre in Barrie, there are a few other steps you should take and information you should know before driving yourself in to get tested.
“This is not going to be a two-week thing. This is likely going to be our new normal for the next several months. It’s important for people to know how to get care,” said Dr. Monica Wolnik, an emergency physician, medical director of the Huronia Urgent Care Clinic, and co-director of Barrie's COVID-19 assessment clinic.
“In an ideal world, everybody would get a swab to know. There’s a shortage of swabs and right now that’s not going to change,” she said. “Right now, there’s very specific criteria of who qualifies for a swab. The swab is not going to be used on people who seem to be doing fine clinically based on their vital-sign assessment.”
Wolnik says the swab testing kits used worldwide are manufactured in a factory in northern Italy, and their closures have led to a shortage of COVID-19 tests worldwide.
“They’re working at a drastically reduced capacity,” she said.
Wolnik said the criteria for swab eligibility is very specific from public health. Currently, only people who have symptoms and work with vulnerable people are eligible for a swab, such as health-care workers or police officers.
“It’s at the discretion of the doctor at the COVID-19 assessment centre. If they are symptomatic and they are working with vulnerable populations, they will be considered for swab,” said Wolnik.
Mild to moderate symptoms of COVID-19 include a fever (38 degrees and above), cough, shortness of breath, sore throat and headache.
“There will be flu-like symptoms,” said Wolnik. “However, if you have those symptoms, you don’t necessarily need to be checked for COVID. We’d have a clinical suspicion based on those symptoms.
“Right now, we don’t have any solid proof there is community spread, but we have to act like there is because of the lack of availability for testing,” she added.
Wolnik said people who have travelled are the most likely carriers at this point.
“If you’ve travelled anywhere – in Canada or out of Canada – you need to be self-isolating for 14 days,” she said. “You don’t need to get checked just because you were travelling.”
The goal of testing right now is primarily to prevent the virus from spreading, not necessarily to identify all existing cases.
Wolnik is sympathetic that people are likely anxious about the pandemic, but practically, the purpose of the assessment site is not to provide comfort.
“The majority of people (who have attended) have very few symptoms,” said Wolnik. “They were just looking for reassurance.
“When people get sicker next week and the week after when we see more of the illness spread into the community, which is inevitably going to happen, this is why we need to be super vigilant about, if you have mild of moderate symptoms, it’s still not a reason to go to (the assessment centre). It’s only if things are getting worse and you can’t manage it at home,” she added.
If you are worried you might have the coronavirus, here are the steps you should take.
Step 1: Use the online assessment tool
“It’s important for people to go there (first) to see, do you even have the right symptoms? Because if you don’t have those symptoms, you don’t need to go,” said Cathy Clark, director of safety, security and occupational health at RVH. “We’re really trying to encourage people to stay home as much as possible and practise social distancing.
“Going on the Ministry of Health website and using that tool is an important first step,” she added.
To access the online assessment tool, click here.
Step 2: Call Telehealth Ontario
“People should call the Telehealth Ontario line before they attend an assessment centre,” said Clark.
Telehealth Ontario nurses can help patients determine if their symptoms are more ambiguous and can make suggestions over the phone.
However, due to Telehealth Ontario seeing higher-than-normal call volumes, there’s one more call Wolnik suggests people should make before going to the COVID-19 assessment centre.
“Telehealth is getting overwhelmed, which is where I think some people are getting frustrated and panicky,” said Wolnik.
For the Telehealth Ontario phone number and more information on Telehealth, click here.
Step 3: Call your family doctor’s office
While a family doctor won’t be able to determine whether you have COVID-19 or not, Wolnik says they should be able to tell you if you’re sick enough to be assessed, sometimes even just over the phone.
“Most people just have cold and flu symptoms and are just anxious they may have it,” she said. “You can call your family doctor to get advice on what you should do. The doctors are happy to get those phone calls to help people understand what’s going on.
“They can also tell you what to look for in case your symptoms worsen,” she added.
Step 4: Visit your local assessment site
“This is a place for people to attend that have COVID-19-like symptoms,” said Clark.
But Wolnik clarifies that the assessment centre isn’t tasked with testing for COVID-19.
“We assess if you are sick enough to be treated for health issues that may be related to COVID-19,” she said. “We don’t want people going to the centre just to get a check up. We want people going there because they are worried they are getting sicker than your average cold and flu symptoms.”
When attending, there may be a line to enter. Patients are asked to wash their hands, put on a mask and register, which includes leaving your name and cellphone number.
“Patients who have travelled by their own car are invited to wait in their cars if they like, to keep social distancing,” said Clark, adding there is a very small waiting area for people who do not come by car. “They can bring a book... whatever they want to do in their car for that wait time.”
When their number is up, patients are called on their cell phones and invited to come back into the assessment centre to see a triage paramedic first, then a physician.
The assessment is done through a form and checking of vital signs through pulse, respiratory rates, blood pressure and oxygen saturation.
“If patients require a (COVID-19) test, that will be communicated to them,” said Clark.
Step 5: Referral for further evaluation
“(Patients) will get a physical paper referral saying they have been seen and assessed by a physician, and based on very specific criteria, they need to be seen in emergency. If they qualify for a swab test but don’t need to be seen by a physician, they’ll just get the swab and go,” said Wolnik.
The swab test consists of a long Q-tip-like swab that goes up the nose and into the back of the throat. Results come back from the test in three to five days.
“Right now, the labs are overwhelmed,” said Wolnik. “They’re trying to expedite (the tests). Currently, people who are swabbed at RVH are sent home afterward.”
Step 6: Self-isolate at home
Currently, there is no cure or treatment for COVID-19 aside from self-isolating at home.
“There is no treatment for a virus,” said Wolnik. “It’s just supportive care, just like you would treat yourself if you had a bad case of the flu, a cold or even pneumonia with fluids, rest or over-the-counter medications.”
Wolnik said there has been some controversy over the benefits of using ibuprofen for coronavirus symptoms.
“Some studies have found it’s safer to use Tylenol or acetaminophen-based products,” she said.
Wolnik said self-isolation should continue until you have been symptom-free for at least 24 hours.
Lastly, Wolnik says no clinic or hospital anywhere will give you a note to clear you go to back to work.
“Employers cannot, during this period of time, ask for a COVID-19 assessment or a doctor’s note to be returning to work,” she said.
For up-to-date information from the health unit on COVID-19, click here.
